lundi 13 janvier 2014

how to remove a stuck ring with string

Ring removal string technique



Another day, another trick of the trade.
Today we have a patient presenting with a very painful wrist after slipping on the icy driveway as she was retrieving her Sunday paper.
She has no obvious deformity and no neurovascular compromise but her hand is quite swollen so we better get that ring off whilst we still can.
….but curses! It doesn’t seem to want to slip over her knuckle, even after an obscene lathering of KY jelly.
Now it transpires that this ring has a lot of sentimental as well as monetary value…..so before we reach for the ring cutter let us offer them this option..….

step 1.

First pass a decent length of strong suture material (we actually have some thick fishing line set aside for just this purpose) under the ring.
Have the longer end on the distal side of the ring.
This method should never be considered if you suspect a fracture of the finger.

step 2.

Take this distal end of the string and begin wrapping it snugly around the finger. Continue wrapping around and around, spiralling over the knuckle and down the finger.
This can become a little uncomfortable(nurses code for painful) for the patient, so try to do this smoothly and quickly. Let them know it might hurt a bit but will probably save their ring from a costly trip to the jewellers.

step 3.

Next, and this requires a little practice, hold the distal end of the string against their finger, grab the proximal end.
Unwind the string, moving around the finger, whilst pulling firmly and maintaining tension.
Continue pulling on the string and unwinding it ‘over’ and ‘around’ the ring…..with a little luck the ring will slowly slide down and off the patient’s finger earning you some rightful admiration. (Keep the ring cutters handy in case it becomes too uncomfortable or fails to budge.)
We have an electric ring cutter that will slice through most rings if we need to get them off in a hurry.

step 4.

Now..give it a quick polish. (KY Jelly brings jewellery up a treat.) Present the intact ring to her, quickly reassess the neurovascular status of the finger and calmly proclaim, “just doing my job ma’am …..just doing my job.”
Walk a way with a barely perceptible swagger in your step.

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